Household Information
* State--Select State-- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
* StatusPlease Select One Single Engaged Married Partnered Separated Divorced Widowed
* Have you (or your partner/spouse) been recently been affiliated with any other synagogues?Please Select One Yes No If you have been a CBE member before, please select Yes, and write in the years of your previous membership.
* Do you (or your partner/spouse) have friends or relatives who are current CBE members?Please Select One Yes No
Adult 1 Information
* Were you raised in the Jewish faith?Please Select One Yes No
* Please choose one from the following listPlease Select One Reform Conservative Orthodox Reconstructionist Traditional Cultural
Have you had a Bar/Bat Mitzvah? Please Select One Yes No
If you converted to Judaism, please enter the date, name, and location of your conversion ceremony, and feel free to describe your experience. If you are in the process of converting or may want to convert in the future, please note that as well.
Additional Family Members
* Is there another adult in your household?Please Select One Yes No
* Do you have children under the age of 18?Please Select One Yes No
* Do you have children over the age of 18?Please Select One Yes No
Adult 2 Information
* Were you raised in the Jewish faith?Please Select One Yes No
* Please choose one from the following listPlease Select One Reform Conservative Orthodox Reconstructionist Traditional Cultural
Have you had a Bar/Bat Mitzvah? Please Select One Yes No
If you converted to Judaism, please enter the date, name, and location of your conversion ceremony, and feel free to describe your experience. If you are in the process of converting or may want to convert in the future, please note that as well.
Child 1 Information (Under 18)
What is your child's grade as of September 2019? Please Select One Younger than Pre-K Pre-K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
* Will your child attend the Early Childhood Center?Please Select One Yes No Maybe
* Will your child attend Yachad (K-12 Jewish education)?Please Select One Yes No Maybe
* Has your child had (or will your child have) a Bar/Bat Mitzvah?Please Select One Yes No Maybe
* Does your child live at home with you full-time?Please Select One Yes No
* Do you have a second child under the age of 18?Please Select One Yes No
Child 2 Information (Under 18)
What is your child's grade as of September 2019? Please Select One Younger than Pre-K Pre-K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
* Will your child attend the Early Childhood Center?Please Select One Yes No Maybe
* Will your child attend Yachad (K-12 Jewish education)?Please Select One Yes No Maybe
* Has your child had (or will your child have) a Bar/Bat Mitzvah?Please Select One Yes No Maybe
* Does your child live at home with you full-time?Please Select One Yes No
Do you have a third child under the age of 18? Please Select One Yes No
Child 3 Information (Under 18)
What is your child's grade as of September 2019? Please Select One Younger than Pre-K Pre-K 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
* Will your child attend the Early Childhood Center?Please Select One Yes No Maybe
* Will your child attend Yachad (K-12 Jewish education)?Please Select One Yes No Maybe
* Has your child had (or will your child have) a Bar/Bat Mitzvah?Please Select One Yes No Maybe
* Does your child live at home with you full-time?Please Select One Yes No
Child1 Information (Over 18)
* My child is: Please Select One Single Engaged Married In a domestic partnership Prefer not to say
* Does your child live at home with you full-time?Please Select One Yes No
* Do you have a second child over the age of 18?Please Select One Yes No
Child 2 Information (Over 18)
* My child is: Please Select One Single Engaged Married In a domestic partnership Prefer not to say
* Does your child live at home with you full-time?Please Select One Yes No
* Do you have a third child over the age of 18?Please Select One Yes No
Child 3 (Over 18) Information
* My child is: Please Select One Single Engaged Married In a domestic partnership Prefer not to say
* Does your child live at home with you full-time?Please Select One Yes No
Yahrzeit Information
* Do you have a loved one whose name you would like to be placed on our Kaddish list (they do not need to have been Jewish)?Please Select One Yes No Yes but I dont have their information at this time. I will get back to you. There will be an opportunity to add additional names.
* Would you like Yahrzeit observed according to the Gregorian calendar or Hebrew calendar?Please Select One Hebrew Gregorian I have no preference (will be observed based on the Gregorian calendar)
Do you have additional loved ones whose names you would like to be placed on our Kaddish list? Please Select One Yes No
* Would you like Yahrzeit observed according to the Gregorian calendar or Hebrew calendar?Please Select One Hebrew Gregorian I have no preference (will be observed based on the Gregorian calendar)
Do you have additional loved ones whose names you would like to be placed on our Kaddish list? Please Select One Yes No
* Would you like Yahrzeit observed according to the Gregorian calendar or Hebrew calendar?Please Select One Hebrew Gregorian I have no preference (will be observed based on the Gregorian calendar)
Additional Information
* Please tell us a little bit about why you are joining CBE.
Is there anything else you would like to share with us (such as special interests or areas of expertise)?
Membership Category and Payment Information
* In which membership category do you (and your partner/spouse) belong? Please note that if you have two adults in your household, you must select the age category based on the older person. Please also note that if there are two adults in your household, you BOTH need to join (you may not select an individual membership). We feel that it's important for all family members to be welcomed and included at CBE's events, programs and services.Please Select One Under Age 30 One Adult- $385 Under Age 30 Two Adults- $615 Age 30-35 One Adult- $1145 Age 30-35 Two Adults - $1525 Age 36-69 One Adult (with no children at home) - $1965 Age 36-69 One Adult (with children at home)- $2350 Age 36-69 Two Adults (with or without children) - $3125 Senior (70 and above) One Adult- $1735 Senior (70 and above) Two Adults- $2660 Out of Town/Affiliate- You live outside NYC or are a member of a different local synagogue. Does not include High holy day tickets or any tuition discounts- $780
* In setting the rate of membership dues, CBE seeks to balance financial sustainability with wide accessibility to the community. The costs of running CBE are substantial and membership dues only cover a portion of the cost. For those with the financial capacity, we offer the voluntary opportunity to contribute a total of $6,215 (instead of the dues rate prescribed by your membership category above). Do you wish to be a Tzedek Member?Please Select One Yes Not at this time
* Please select the method of payment you will be using to take care of your membership dues. Once your application is submitted and reviewed, Sam Sterling, the Director of Membership and Engagement will reach out to help you finalize your membership account.Please Select One I/We will be paying by credit card. I/We will be paying by ACH debit.
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